What Will It Take to Achieve Health Equity?

African Americans have higher rates of morbidity and mortality from cancer, HIV, many sexually transmitted diseases, Hepatitis A, and tuberculosis. According to the Boston Public Health Commission, babies born to black women are more likely to die in their first year of life than babies of white women. Hundreds of studies and statistics over the past century have shown such health disparities. 

The Affordable Care Act (ACA), passed in 2010, promised to promote preventative medicine, increase health insurance coverage to nearly all Americans, and strengthen and expand public healthcare services.  The act supports the US Health and Human Services’ Healthy People 2020 priority to achieve health equity, eliminate disparities, and enhance healthcare for all. As of March 2015, approximately 2.3 million African American adults had gained health insurance as a result of the ACA. Yet the Act has still left many disappointed. With the new administration entering office, many seek to override the Affordable Care Act. But the fact is, that the health insurance system alone will not be what closes the gap in health outcomes between African Americans and white Americans. Any new program will still have its critics and leave some of the now-hopefuls disappointed.

Access to health insurance is not the sole determinant of health and all of the factors that determine health can, one way or another, be impacted by or are a result of racial background. Determinants of health include income, education, access to healthy foods, proximity to quality doctors and hospitals, flexible time to make and keep appointments, and lifestyle factors like stress levels. African Americans are more likely to suffer social stressors due to racism which can impact daily lives and job and education opportunities. Stress is a leading cause of chronic conditions.

There is no single solution to close the disparity gap. It will take years of effort and all determinants must be addressed. Those seeking health equity will continue to be disappointed if they rely on the health insurance system structure to be the standalone solution.

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